• Korean Journal of Community Nutrition
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• v.6 no.1
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• pp.76-83
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• 2001

This study was designed to determine serum osmolality and to investigate the association among serum osmolality, health-related factors and biochemical indices. Two hundred thirty seven elderly(86 male, 151 female : mean age 73.8) residing in the chungbuk area participated. Sociodemographic data and self-perceived health status were obtained by interview, and biochemical parameters were measured. The mean serum osmolaity was 301.2$\pm$10.1 mOsm/kg(range 240.8~328.9 mOsm/kg) and serum osmolality of the females(302.4 mOsm/kg) was significantly(p＜0.05) higher than that of the males(299.0 mOsm/kg). Only 11.0% of the elderly were within the accepted normal range(280~295 mOsm/kg) and the majority of the subjects were in a hyperosmolar state(60.8% : 296~307 mOsm/kg). It was observed that serum osmolality was reduced with increasing age but not statistically significant. There was no significant difference in serum osmolality according to marital status. Serum osmolality was significantly lower(p＜0.05) in the elderly with higher self-perceived health scores than the elderly with lower self-perceived health scores, however no significant difference was observed between the presence or absence of disease. Serum osmolality tended to be higher(p=0.06) in the elderly with difficulty in mobility than the elderly who have no problem in mobility. Serum osmolality tended to be higher(p=0.06) among drug users compared to that of non-users. There was a significant association between serum osmolality and serum albumin in females but not in males. Significant associations were shown between serum osmolality and serum transferrin in both sexes. However, there was no significant correlation between serum osmolality and hemoglobin or hematocrit except with hematocrit in females only. The results of this study indicated that the elderly were dehydrated and hydration state seems to influence health status and, the elderly should be encouraged to drink an adequate amount of fluids. Also, the hydration state is required to be assessed and considered for the interpretation of biochemical parameters.

• The Journal of Korean Medicine
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• v.21 no.1
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• pp.99-102
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• 2000

Central diabetes insipidus(CDI) results from deficient vasopressin(antidiuretic hormone) secretion and causes polydipsia and polyuria. Its etiologic diagnosis is confirmed with an increase of urine osmolality by administering desmopressin(DDAVP) after water restriction. Because cm is caused by deficiency of vasopressin, up to now, desmopressin, a synthetic analog of vasopressin, has been the drug of choice in the treatment of CDI. However, under such treatment, CDI patients suffer from the continual administration of DDAVP throughout one's life and high cost of the treatment We administrated oriental herb medicine on a cm patient in a state of discontinuance of DDAVP. Prior to the study, brain sella MRI was scanned to exclude germinoma. In addition, urine analysis, serum and urinary osmolality, daily urinary volume, serum electrolyte levels were measured. Chungsimyunjatang was administered for 15 days, and urine analysis, urine osmolality, daily urinary volume, serum Na were measured several times again during the therapy, As a result, urinary frequency increased, serum Na slightly elevated, but specific gravity of urine, urinary osmolality severely decreased and daily urinary volume substantially increased. However, the frequency of DDAVP treatment was reduced from four times per day to once or twice a day with the continual administration of the Chungsimyunja-tang for two months after the discharge.

• Journal of Yeungnam Medical Science
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• v.9 no.1
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• pp.110-120
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• 1992

The purpose of this study was to prevent the dilutional effect of excessive absorption of irrigating solution by using furosemide intraoperatively during transurethral resection of the prostate, 30 patients, who belonged to physical status II or III of ASA classification, were selected randomly and divided with two groups as follows : G1(N=15) : Not-administrated furosemide(control group) G2(N=15) : Administrated furosemide(Experimental group). All patients were premedicated with Hydroxyzine(1mg/kg, IM) and were performed continous epidural anesthesia with 2% lidocaine(1-1.5mg/segment). For irrigating solution, 5% D-sorbitol was used and Hartman's solution were given for maintenance fluid and fixed the height of irrigating container to 60 cm from symphysis pubis. With the starting of operation, 20mg furosemide was administrated to experimental group. The blood samples for the values of $Na^+$, $K^+$, Glucose and BUN were performed at the periods of preoperation, 10 min, 20 min, 30 min after the starting of operation and immediate postoperation. Based these data, serum osmolality and effective osmolality were calculated. The results were as follows : 1. The sodium concentration of control group was decreased statistically significantly at 10 min, 20 min, 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value(p<0.05). But that of experimental Group was not changed significantly. 2. The serum osmolality and effective osmolality were decreased statistically significantly at 30 min after the starting of operation and immediate postoperative period as comparing with the preoperation value(p<0.05). But those of experimental group were not changed significantly. These results show that the dilutional effect of excessive absorption of irrigating solution might be prevented by using furosemide intraopertively. And so we recommend the use of furosemide during TURP, especially in patients with congestive heart failure or renal failure.

• Journal of The Korean Society of Clinical Toxicology
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• v.17 no.2
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• pp.47-57
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• 2019

Purpose: Osmolar gap (OG) has been used for decades to screen for toxic alcohol levels. However, its reliability may vary due to several reasons. We validated the estimated ethanol concentration formula for patients with suspected poisoning and who visited the emergency department. We examined discrepancies in the ethanol level and patient characteristics by applying this formula when it was used to screen for intoxication due to toxic levels of alcohol. Methods: We retrospectively reviewed 153 emergency department cases to determine the measured levels of toxic ethanol ingestion and we calculated alcohol ingestion using a formula based on serum osmolality. Those patients who were subjected to simultaneous measurements of osmolality, sodium, urea, glucose, and ethanol were included in this study. Patients with exposure to other toxic alcohols (methanol, ethylene glycol, or isopropanol) or poisons that affect osmolality were excluded. OG (the measured-calculated serum osmolality) was used to determine the calculated ethanol concentration. Results: Among the 153 included cases, 114 had normal OGs (OG≤14 mOsm/kg), and 39 cases had elevated OGs (OG>14). The mean difference between the measured and estimated (calculated ethanol using OG) ethanol concentration was -9.8 mg/dL. The 95% limits of agreement were -121.1 and 101.5 mg/dL, and the correlation coefficient R was 0.7037. For the four subgroups stratified by comorbidities and poisoning, the correlation coefficients R were 0.692, 0.588, 0.835, and 0.412, respectively, and the mean differences in measurement between the measured and calculated ethanol levels were -2.4 mg/dL, -48.8 mg/dL, 9.4 mg/dL, and -4.7 mg/dL, respectively. The equation plots had wide limits of agreement. Conclusion: We found that there were some discrepancies between OGs and the calculated ethanol concentrations. Addition of a correction factor for unmeasured osmoles to the equation of the calculated serum osmolality would help mitigate these discrepancies.

• Korean Journal of Veterinary Service
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• v.45 no.2
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• pp.139-143
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• 2022

A 10-year-old, spayed female miniature schnauzer was referred to the Veterinary Medical Teaching Hospital of Chungnam National University due to evaluation of sudden polyuria (PU) and, polydipsia (PD) (540 mL/kg/day) with severe anemia and weight loss. Blood examination results were normal except for severe anemia (hematocrit, [HCT]: 11.8%). Urinalysis revealed a urine specific gravity (USG) of 1.003, whereas urine sediment was not specific. Urine osmolality was 90 mOsm (reference range: 800~2500 mOsm), and plasma osmolality was 303 mOsm. No specific lesions were found using diagnostic imaging including radiography, ultrasonography and magnetic resonance imaging (MRI). The serum cortisol level was normal in cosyntropin stimulation test. Plasma arginine vasopressin (AVP) concentration was <0.4 pg/mL (reference range: 3.49~5.45 pg/mL). Blood transfusion was initiated in addition to an oral prescription of desmopressin acetate (DDAVP, 0.1 mg/head) thrice a day for one week. The patient was rechecked for clinical signs, urine osmolality, and USG; the clinical signs of PU/PD were resolved, urine osmolality increased to 1106 mOsm, and, USG increased to 1.021. Considering the improved clinical signs, and increased urine osmolality, and USG after DDAVP treatment, the dog was diagnosed with central diabetes insipidus. USG and urine osmolality increased to >1.030 and 2200 mOsm, respectively. Anemia also gradually improved and HCT increased to >37%. DDAVP was tapered to 0.1 mg/head twice a day and all clinical signs in the patient have completely resolved.

• Neonatal Medicine
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• v.25 no.3
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• pp.131-135
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• 2018

Hyponatremia is defined as a plasma sodium concentration of <135 mEq/L. It is a common electrolyte imbalance in newborns. We report the case of a term neonate with cleft lip, cleft palate, imperforate anus, normal male karyotype, and chronic hyponatremia. On the 4th day of life, he showed hyponatremia (plasma sodium concentration 130 mEq/L) with low serum osmolality (275 mOsm/kg), high urine sodium (116.7 mEq/L), and high urine osmolality (412 mOsm/kg). His thyroid and adrenal functions were normal. Despite intravenous and oral sodium supplementation and hydrocortisone treatment, hyponatremia persisted. Brain magnetic resonance imaging showed normal results. He was diagnosed as having reset osmostat, a rare subtype of the syndrome of inappropriate secretion of antidiuretic hormone characterized by a subnormal threshold for antidiuretic hormone secretion, with hypotonic hyponatremia.

• Clinical and Experimental Pediatrics
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• v.59 no.4
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• pp.202-204
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• 2016

A 15-year-old boy, who was diagnosed with Alport syndrome and end-stage renal disease, received a renal transplant from a living-related donor. On postoperative day 1, his daily urine output was 10,000 mL despite normal graft function. His laboratory findings including urine, serum osmolality, and antidiuretic hormone levels showed signs similar to central diabetes insipidus, so he was administered desmopressin acetate nasal spray. After administering the desmopressin, urine specific gravity and osmolality increased abruptly, and daily urine output declined to the normal range. The desmopressin acetate was tapered gradually and discontinued 3 months later. Graft function was good, and urine output was maintained within the normal range without desmopressin 20 months after the transplantation. We present a case of a massive polyuria due to transient deficiency of antidiuretic hormone with the necessity of desmopressin therapy immediately after kidney transplantation in a pediatric patient.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.54 no.5
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• pp.676-684
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• 2021

Euryhaline teleost have extraordinary ability to deal with a wide range of salinity changes. To study the seawater adaptability of rainbow trout Oncorhynchus mykiss (body weight 638±54 g, length 38.6±2 cm) to salinity increase fish were transferred from freshwater to 7, 14, 21, 28 and 32 psu and checked for mortality over 5 days. No mortality was observed in 0-32 psu. In fish transferred to 0-32 psu, blood osmolality was maintained within physiological range. The changes of serum enzyme activities (aspartate transaminase, AST and alanine transaminase, ALT) showed no significant level during experimental period. To explore the underlying molecular physiology of gill and kidney responsible for body fluid regulation, we measured mRNA expression of five genes, Na⁺/K⁺/2Cl^- cotransporter1 (NKCC1), aquaporin3 (AQP3), cystic fibrosis transmembrane conductance regulator (CFTR), glucocorticoid receptor (GR) and growth hormone receptor (GHR) in response to salt stress. Based on our result, rainbow trout could tolerate gradual transfer up to 32 psu for 5 days without mortality under physiological stress. This study suggests to alleviate osmotic stress to fish, a gradually acclimation to increasing salinity is recommended.

• Korean Journal of Fisheries and Aquatic Sciences
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• v.55 no.6
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• pp.894-902
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• 2022

This study investigated the effects of photoperiod (NL 12L:12D and LL 24L:0D) and body sizes (30 g and 50 g) on parr-smolt transformation, post-smolt growth and blood properties in the off-season parr-smolt stage of Atlantic salmon reared in a recirculating aquaculture system (RAS). Potential off-season salmon smolt were reared in a freshwater RAS for 80 days and then all experimental fish were transferred to seawater. In both LL groups (LL-30 and LL-50), we recorded and increase in specific growth rate and reduction in feed conversion, although there were no significant difference in body size. The values of osmolality, and serum Na⁺, Cl^- and cortisol concentrations in the LL groups were maintained at lower levels than in NL group fish, and LL group fish were observed to recover to the pre-seawater adaptation state more rapidly than those in the NL group. ID chips were inserted in all smolts reared in freshwater. These fish were subsequently transferred to full-strength seawater and thereafter individual growth rates were monitored for 120 days. The results indicated that compared with smolt reared under natural photoperiodic condition, 24 h lighting in freshwater contributed to enhancing post-smolt specific growth rate in seawater.

• Journal of Aquaculture
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• v.16 no.3
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• pp.151-158
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• 2003

This study was conducted to estimate the effects of residual chlorine dioxide ($CIO_2$) in chlorinated seawater on survival and physiological responses (hematocrit: Ht, hemoglobin: Hb, serum electrolyte and glucose levels, and osmolality) of olive flounder, Paralichthys olivaceus. All the flounders were exposed for 10 min to different concentrations of residual $CIO_2$ just after chlorination for 1 min in each experimental aquarium (EA). ClO$_2$-free seawater was continuously supplied to each EA after 10 min exposure to $CIO_2$. By means of probit analysis, the median lethal times (LT$_{50}$, min) of flounder exposed to 0.43 and 0.51 ppm $CIO_2$, were at 103 and 32 min, respectively. In the range from 0.34 to 0.51 ppm $CIO_2$, the values of Ht, Hb, electrolytes and osmolality of fish exposed to $CIO_2$ were significantly elevated as elapsed time and residual concentrations of $CIO_2$ increased after chlorination. The levels of Ht, Hb, electrolytes and osmolality in flounder exposed to 0.27 ppm $CIO_2$ were not significantly different compared to control fish, which were maintained in $CIO_2$-free seawater; however, the levels of serum glucose were significantly increased with elapse times.